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Levothyroxine, also known as L-thyroxine, is a synthetic form of the thyroid hormone thyroxine (T 4). [5] [8] It is used to treat thyroid hormone deficiency (hypothyroidism), including a severe form known as myxedema coma. [5]
Liothyronine may be used when there is an impaired conversion of T 4 to T 3 in peripheral tissues. [2] The dose of liothyronine for hypothyroidism is a lower amount than levothyroxine due it being a higher concentrated synthetic medication. [2]
The major form of thyroid hormone in the blood is thyroxine (T 4), whose half-life of around one week [4] is longer than that of T 3. [5] In humans, the ratio of T 4 to T 3 released into the blood is approximately 14:1. [6] T 4 is converted to the active T 3 (three to four times more potent than T 4) within cells by deiodinases (5′-deiodinase).
Levothyroxine is the mainstay of treatment for people with hypothyroidism, [13] while people with hyperthyroidism caused by Graves' disease can be managed with iodine therapy, antithyroid medication, or surgical removal of the thyroid gland. [14]
The term injection encompasses intravenous (IV), intramuscular (IM), subcutaneous (SC) and intradermal (ID) administration. [ 35 ] Parenteral administration generally acts more rapidly than topical or enteral administration, with onset of action often occurring in 15–30 seconds for IV, 10–20 minutes for IM and 15–30 minutes for SC. [ 36 ]
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Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
There are reported cases of goiter and choanal atresia in fetus. [5] Furthermore, breast feeding is possible but only if lowest effective dose is used and neonatal development is closely monitored. For the above reasons, it is preferable to use PTU in pregnancy, especially in the first trimester, with the possibility of changing to carbimazole ...
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